Ribeiro Camila Dos Santos, Pratesi Claudia B, Zandonadi Renata Puppin
Department of Nutrition, University of Brasília, Brasília 70910-900, Brazil.
College of Population Health, University of New Mexico, Albuquerque, NM 87131, USA.
Nutrients. 2025 Jun 8;17(12):1956. doi: 10.3390/nu17121956.
Celiac disease (CD) is an autoimmune condition triggered by gluten ingestion. The only effective treatment is adherence to a gluten-free diet (GFD), which is challenging due to the widespread presence of gluten in foods and the lack of physical and financial access to gluten-free options, among other factors that can lead to food nutrition insecurity (FNI). FNI, defined as the difficulty in accessing adequate food, is a factor that not only affects the need to adhere to a GFD but also compromises adherence itself. Review the scientific literature on the association between FNI, celiac disease, and adherence to a gluten-free diet. This integrative review was conducted systematically using the PubMed, Scopus, and Web of Science databases, selecting studies that evaluated food security and insecurity among celiac patients. The keywords used with the Boolean operators were "celiac disease" AND/OR "gluten-free diet" AND "food insecurity" AND/OR "food security". The search did not restrict language or geographic location, and studies were selected independently by two reviewers. Ten publications met the inclusion criteria and were selected for the integrative review. FNI has been studied over the last five years in CD patients, but there is a lack of studies in different regions. FNI negatively affects the quality of life for those with CD and contributes to more severe symptoms and lower adherence to the GFD, especially in children and low-income families. Factors associated with higher risks of FNI in those with celiac disease include income, education, living in rural or non-central areas, and availability. These factors reinforce the negative impact of the association between FNI and adherence to the GFD in CD patients. The study of FNI in celiac individuals is a relatively recent development. The prevalence of FNI in this population is concerning and higher than in the general population, and it is associated with adherence to the GFD. Therefore, this topic demands extensive public policies to improve the health, quality of life, adherence, and treatment of CD patients.
乳糜泻（CD）是一种由摄入麸质引发的自身免疫性疾病。唯一有效的治疗方法是坚持无麸质饮食（GFD），然而由于食物中普遍存在麸质，以及缺乏获取无麸质食品的实际途径和经济能力等其他可能导致食物营养不安全（FNI）的因素，坚持这种饮食颇具挑战性。FNI被定义为获取充足食物存在困难，它不仅影响坚持GFD的必要性，还会损害坚持本身。回顾关于FNI、乳糜泻和坚持无麸质饮食之间关联的科学文献。本整合性综述使用PubMed、Scopus和Web of Science数据库系统地进行，选择评估乳糜泻患者食品安全和不安全状况的研究。与布尔运算符一起使用的关键词是“乳糜泻”和/或“无麸质饮食”以及“食物不安全”和/或“食品安全”。搜索不限制语言或地理位置，由两位评审员独立选择研究。十篇出版物符合纳入标准并被选入整合性综述。在过去五年中对CD患者的FNI进行了研究，但不同地区的研究较少。FNI对CD患者的生活质量有负面影响，并导致更严重的症状和对GFD的依从性降低，尤其是在儿童和低收入家庭中。乳糜泻患者中与FNI风险较高相关的因素包括收入、教育程度、居住在农村或非中心地区以及可获得性。这些因素强化了FNI与CD患者坚持GFD之间关联的负面影响。对乳糜泻个体的FNI研究是一个相对较新的进展。该人群中FNI的患病率令人担忧且高于一般人群，并且它与坚持GFD有关。因此，这个话题需要广泛的公共政策来改善CD患者的健康、生活质量、依从性和治疗效果。
Cochrane Database Syst Rev. 2022-2-24
Health Technol Assess. 2001
Cochrane Database Syst Rev. 2018-2-6
Cochrane Database Syst Rev. 2023-2-8
Nutrients. 2025-3-31
N Engl J Med. 2025-2-13
J Pediatr Gastroenterol Nutr. 2024-12
Gastroenterology. 2024-6
Curr Nutr Rep. 2023-6
Zotero 插件